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Medical narratives in empirical frameworks.

Article Excerpt
Abstract

This paper examines the use of narrative in medical and scientific research writing by analyzing the research report and the grant proposal, genres familiar to many health care educators and practitioners. It is our intention to outline a pedagogical paradigm based in rhetoric and composition theory which we feel teaches both healthcare professionals and medical researchers to write within (and for) particular workplace environments which seek to provide patient and public health information to a variety of audiences. Narrative has a place in the pedagogy of technical communication for both groups. For technical writers who present complex research and medical information to wider audiences, an understanding of narrative elements present in research writing provides a way to read and interpret, as well as write. Our focus here is on medical researchers where narrative provides an approach to the strict empirical formats they must use in ways which make them more flexible and persuasive. We begin with a theoretical framework for teaching narrative in science and medical research writing in the strict IMRAD (introduction, methods and materials, research and discussion) and in grant-writing, demonstrate the idea of narrative in pedagogical practice, and end with a brief discussion of the implications of using narrative in medical research writing.

Introduction

In recent years, the place and value of narrative in healthcare and the practice of medicine has been clearly established. Studies in patient-physician interaction (Kleinman 1988, Hunter 1991) and in clinical practice (Mattingly 1989, 1998) have explored the ways in which storytelling provides a basis for understanding and surviving illness. But narrative is often regarded as outside the province of medical research writing; as it has been traditionally taught, medical research writing is a domain where language is spare, strict and disciplined, figurative language is nearly non-existent, formal organization and brevity dictate structure and "narrative voice hardly occurs" (Eisenberg 1992, p. 58). In short, it has been argued that medical research writing, especially as portrayed in trade journals, research reports and grant-writing belongs in an arena where no narrative structure is present and no identifiable narrative voice is telling the story. Viewed in this light, medical and scientific research seems a formal discipline, cool and far removed from the chaotic tangle of human endeavor. But if this is the view customarily held by medical and professional writers, it is strangely at odds with the way in which many doctors and scientists view both their work and their writing. In actuality, medical science and research writing are full of storytelling. In several genres common to medical research writing the use of narrative is apparent and it is useful to explicate how healthcare practitioners as well as communication professionals such as writing instructors can teach narrative as an effective means of communicating issues in science and medicine.

In recent years, rhetoricians have emphasized how the conventions of scientific texts operate to define scientific work as a collective, cooperative inquiry. Such a definition combines elements of Aristotelian and contemporary rhetoric. Gross (1990) provides a more contemporary rhetoric that includes both logic and dialectic. Also, departing from Aristotle's differentiation between dialectic and rhetoric, Pera (1991) views scientific rhetoric as "the set...

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